<include file="Public:header" />
<div class="main">
    <div class="box_tit">
        <h2>修改订单收货信息</h2>
    </div>
    <div class="form_list">
        <form method='post' id="form1" name="form1" action="{:U('Couponorder/address_edit_insert')}"  enctype="multipart/form-data">
        <div class="listtop">

        <dl>
            <dt> 姓名：</dt>
            <dd>
                <input type="text" class="ipt6" name="name" value="{$vo.name}">
            </dd>
        </dl>
        
        <dl>
            <dt> 手机：</dt>
            <dd>
                <input type="text" class="ipt6" name="mobile" value="{$vo.mobile}">
            </dd>
        </dl>
        
        <dl>
            <dt> 省份：</dt>
            <dd>
                <select name="province" id="province" class="ipa6" onchange="loadRegion('province',2,'city','{:U('Ajax/getRegion')}');">  
				<option value="" selected class="defaultoption">不限省份</option>
		        <volist name="province" id="mvo"> 
		        <option value="{$mvo.id}" <eq name="mvo.id" value="$vo.province">selected="selected"</eq>>{$mvo.name}</option>
		        </volist>
				</select>
            </dd>
        </dl>
        
        
        <dl>
            <dt> 城市：</dt>
            <dd>
                <select name="city" id="city" class="ipa6" onchange="loadRegion('city',3,'town','{:U('Ajax/getRegion')}');">  
				<option value="{$vo.city}" selected class="defaultoption">{$vo.city|getRegion}</option>
				</select>
            </dd>
        </dl>
        
        <dl>
            <dt> 地区：</dt>
            <dd>
                
				<select name="town" id="town" class="ipa6" >  
				<option value="{$vo.town}" selected class="defaultoption">{$vo.town|getRegion}</option>
				</select>
            </dd>
        </dl>
        
        <dl>
            <dt> 详细地址：</dt>
            <dd>
            	<textarea name="address" style="width:400px; height:60px; padding-left: 3px; float: left;">{$vo.address}</textarea>
            </dd>
        </dl>
        
        <dl>
            <dt> 备注：</dt>
            <dd>
            	<textarea name="remark" style="width:400px; height:60px; padding-left: 3px; float: left;">{$vo.remark}</textarea>
            </dd>
        </dl>
        
        <div class="form_b">
            <input type="hidden" name="id" value="{$vo.id}">
            <input type="submit" class="submit btn7" id="submit" value="提 交">
        </div>
        </form>
    </div>
</div>

<include file="Public:footer" />